Association of Socio-economic Status with Injuries in Children Andadolescents:the CASPIAN-IV Study

Background:Childhood and adolescence injuries are still frequently occuring in developing countries. This study aims to assess the association  of socio-economic status (SES) with injuriesin Iranian children and adolescents. Materials and Methods: This multicentricsurvey was part of a national surveillance program, which was conducted in 2011-2012 amongst 14,880 students aged6-18 years. Participants were randomly selected from urban and rural areas of 30 provinces in Iran. Socio- economic status (SES) of participants was categorized to “low”, “middle” ,and “high” by using principle component analysis method by considering parental job and education as well as family assets. Prevalence, types and places of injuries were based on the questionnaire of the World Health Organization- Global School-based student Health Survey (WHO-GSHS).Multivariate modelwas used for comparison of variables between SES groups. Results: Overall, 13486 out of 14880 invited students (response rate: 90.6%) participated in this study.Their mean (SD) age was12.47 (3.36) years.Boys and urban residents constituted the majority of participants (50.8% and 75.6%, respectively). Compared with low SES group, odds of sport injury was higher in students with middle (OR=1.44; 95%CI: 0.92-2.26) and highSES (OR=1.96; 95%CI: 1.27-3.01). Compared to participants withlow SES,odds of home injuries was significantly lower in high SES group (OR=0.78; 95%CI: 0.64-0.95). Conclusion: This study revealedconsiderable differences in injuries of children and adolescents according to their SES, with higher prevalence of home injuries in low SES families and higher prevalence of sport injuries in middle and high SES levels. When implementing injury prevention programs, such differences should be taken into account.